August 11, 2008
Florida Provider Part A Interactive Voice Response (IVR) Operating Guide
1-877-602-8816
First Coast Service Options, Inc. (FCSO) strives to provide you with the most up to date automation features as possible. The IVR Operating Guide will help to increase your knowledge of the technology and services we offer our providers.
Hours of Operation
IVR Unit Hours of Availability
The IVR is available 24 hours a day, 7 days a week, except for regularly scheduled maintenance. However, specific claim and/or eligibility information is available during the following times, with the exception of Holidays:
Monday - Friday 6:00 a.m. – 6:00 p.m. EST and CST
Touchtone or Speech
All callers have the option of selecting speech or touchtone when using the IVR. In order to receive maximum, results you deserve when speaking we offer the following tips:
• Use a telephone with a handset or headset
• Avoid using a speakerphone or cell phone
• Avoid calling from areas with loud background noise
• Speak the requested information clearly in a quiet environment
*When using the speech recognition option on the IVR, and keying the date is required (date of service, date of birth, etc.), the date must be given in 8-digit format (mm/dd/yyyy).
In the event the system does not accept the spoken information, touch-tone is always available. In order to receive the maximum results you deserve when using touch-tone we offer the following tips:
• Dates should be entered in the following format (mm/dd/yy)
• To signal you are entering an alpha suffix or letter, press the * key
• Press the key that includes the letter, then the corresponding number that denotes where the letter is located on the number key.
• After all letters desired have been keyed, press the pound (#) sign to end your entry.
Use the numbers on the telephone keypad that corresponds to the patient or provider number:
A = *21#
Q =*72#
R = *73#
Z = *94#
Helpful Tips
As a result of the Health Insurance Portability and Accountability Act (HIPAA), we are required to protect the privacy of all individuals. You must have the following information available for authentication to access patient eligibility, deductible and claims information from the IVR:
• National Provider Identifier (NPI)
• Provider Transaction Access Number (PTAN)
• Beneficiary Medicare Number
• Beneficiary Name,
• Beneficiary Date of Birth
• Date of Service (If applicable)
Main Menu
NUMBER |
OPTIONS |
|---|---|
1 |
Common Questions |
2 |
Claim Status |
3 |
Check Status |
4 |
Publication Information |
5 |
Eligibility |
6 |
Remittance Codes |
7 |
Medicare Advantage (HMO) |
Providers’ Commonly Asked Questions – Press 1
• How to bill a claim, press 1
• How to receive Status of a Claim, press 2
• How to know if a HCPC code is bundled, press 3
• For General Appeals information, press 4
• For Hours of Operation, press 5
Claim Status - Press 2
• For Claim Status, press 1
The IVR voices the following information:
• Type of Bill
• Amount Submitted
• Date Claim Received
• Reimbursement Amount
• Document Control Number (DCN)
• Remittance Advice Date
The IVR voices the following information when it is returned to the Provider:
• Date Claim Received
• Amount Submitted
• Date Returned
• Document Control Number (DCN)
• Reason Code
• Reason for Return
The IVR voices the following on pending claims:
• Date Claim Received
• Amount Submitted
• Document Control Number
• For Status of an Enrollment Application press 2
The IVR voices status on application based on the location of the 15 –digit Correspondence Control Number (CCN) entered:
• Finalized – Application is Approved, Denied, Rejected, or Returned
• Pending – Application has been processed and is pending for approval.
• Returned Development – Application is processing; however additional information is needed.
• Merged – Application has been merged with another application.
If no match is found or the CCN is less than 15 digits – the IVR will voice “We are unable to locate any applications that match the CCN entered.”
Check Information – Press 3
• To obtain the amount of your last check, press 1
• For information on a specific check, press 2
• For information on your last three checks, press 3
Publication Information - Press 4
• For information on Medicare Seminars, press 1
• For information on CMS Publications, press 2
• For information on Medicare Part A Publications, press 3
Eligibility Information - Press 5
• For current eligibility information, press 1
• Part A and B Entitlement Date
• Part A and B Termination Date (if applicable)
• Part B Deductible information
• Full Hospital Days Remaining
• Hospital Co Insurance Days Remaining
• Full Skilled Nursing Facility Days
• Skilled Nursing Facility Co Insurance Days
• Lifetime Reserve Days Remaining
• Lifetime Psychiatric Days Remaining
• Last Billing Date
• Medicare Advantage Information
• Medicare is Primary or Secondary
If Medicare Advantage Plan is found, you can press 1 for more information.
• The IVR will give the Medicare Advantage Number
• Plan Type
• Plan Name
• Effective Dates and Termination Date of Policy
• Address of Medicare Advantage Servicing Provider
If Medicare is Secondary, press 1 for additional MSP details
• Type of Primary Insurance
• Effective and Termination Date for all valid insurers for either Current or Previous date of service.
• For Eligibility for a previous date of service, press 2
• For Physical and Occupational Therapy Information, press 3
Note: After primary eligibility information is obtained, the IVR will prompt the caller to press an option for additional eligibility.
Sub Menu for Additional Eligibility Menu
• Hospice
• Hospice Effective Date
• Termination Date (If Applicable)
• Servicing Provider Number
• Home Health
• Home Health Effective Date
• Termination Date (If Applicable)
• Servicing Provider Number
• Skilled Nursing Facility
• SNF Effective Date
• Termination Date (If Applicable)
• Servicing Provider Number
Definitions of Remittance Codes and Pricing for Procedure Codes - Press 6
• For Remittance Code information, press 1
• For Pricing of a Procedure Code, press 2
Medicare Advantage (formerly known as HMO) information - Press 7
• Caller enters a specific Medicare Advantage Plan Number to receive specific information such as:
• Plan Name
• Type of Plan
• Address of Plan Provider
*Note – The Medicare Advantage Plan Number was formerly known as HMO Plan Number.
Repeat Menu - Press 8
This option returns callers to the main menu
End Call – Press 9
This option ends the call in the IVR.
Additional Information
Customer Service Representatives—Medicare Part A
8:00 a.m. – 4:00 p.m. Monday through Friday (see training time exception noted below), for both the Eastern and Central time zones, excluding holiday closings.
Toll-Free Telephone Number: 1-888-664-4112
Speech and Hearing Impaired: 1-877-660-1759
Training Hours
The Florida Medicare Part A Provider Call Center will typically be closed on Friday afternoons from 2:00 p.m. – 4:00 p.m. for staff training.
Written Inquiries—Medicare Part A Issues
E-mail Address: AskFloridaA@fcso.com
Web site Links
For additional information, please visit the Florida Medicare Web site at www.fcso.com or the Centers for Medicare & Medicaid Services’ (CMS) Web site at www.cms.hhs.gov/home/medicare.asp 
